2024년 미국불임학회(ASRM) P-394 Effect of intralipid immunotherapy on pregnancy rates in patients who have experienced IVF failure. (IVF에 실패 경험이 있는 환자의 임신율에 인트라리피드 면역요법의 효과)

M.J. Kim, S.G. Kim, G.W. Kim, H.J. Son, G.D. Heo, H.Y. Kim, Y.W. Kim, J.Y. Seong, H.K. Noh, K.H. Lee. Mamapapa&baby Ob/Gy Clinic, Baby dream research center, Ulsan, Korea- South.

Objective

Endometrium contains immune cells specifically adapted to tolerate this invading embryo. However, if these 'friendly' cells are not present or do not work effectively the mother’s immune system may attack or reject the embryo with so-called 'natural killer' (NK) cells. This makes it difficult or impossible for the embryo to implant safely in endometrium, resulting in repeated miscarriages or failed implantations.Many studies have shown that intralipid modulates the activity of NK cells in the endometrium of patients with recurrent miscarriages, and unsuccessful IVF attempts, improving the maintenance of successful pregnancies and helping embryos implant in the endometrium and grow normally.
The aim of this study is to determine whether intralipid immunotherapy can help patients who have experienced one or more IVF failures.

Materials and Methods

Respectively, the 293 IVF cases and 1,166 frozen embryo transfer (FET) cases were analyzed in this study.
In this study, 1,459 patients were divided into two groups: those who received intralipid immunotherapy and those who did not (control). Intralipid immunotherapy group received an intralipid infusion on ET day and repeated if ß-hCG test was positive. Pregnancy rates were compared by Chi-squared test.

Results

In each group, there were no significantly difference in age (36.2 ± 4.7 vs. 37.0 ± 4.6 years old) and endometrial thickness (9.9 ± 2.1 vs. 10.2 ± 2.3 ㎜) for IVF and cryo-ET cycle condition. The intralipid group had no significantly effect on the clinical pregnancy rates compared to control group (48.3 vs. 49.6 %, respectively). In addition, as a result of classifying patients by age and examining the effectiveness of intralipid immunotherapy, interestingly, it was found that the pregnancy rate was low in women under 35 years of age (51.7 vs. 63.8 %, respectively). Furthermore, patients were classified according to the history of at least one or more failed IVF cycle. Likewise, it was confirmed that there was no effect in the group under 35 years of age (30.8 vs. 54.2 %, respectively).

Conclusions

Intralipid immunotherapy had a negative effect on pregnancy rates in patients under 35 years of age who had had one or more failed IVF attempts. Therefore, it will be necessary to select an effective patient group through additional research.

Impact Statement

In patients who failed the first IVF, intralipid injection is not effective in improving the pregnancy rate, so it seems necessary to select patients for intralipid injection.

한글요약

체외시술 환자에게 인트라리피드 면역요법이 도움이 되는지 확인 결과, 35세 미만 어린 여성군에서 인트라리피드 면역요법은 임신율을 증가시키지 않았다. 또한, 1회 이상 실패를 경험한 환자에서도 인트라리피드 면역요법의 효과가 나타나지 않았다. 따라서, 인트라리피드 면역요법은 모든 환자에게 효과적인 것은 아니며, 이를 통해 인트라리피드 면역요법은 보다 적절한 대상에게 적용되어야 효과적일 것으로 생각된다.